‘Social prescribing’ exercise benefits smaller than thought

Researchers have argued that the so-called ‘social prescribing’ of exercise to patients may not yield the benefits hoped for.

Exercise referral schemes have been at the disposal of GPs since the 1990s, in an attempt to boost activity levels in people with long-term conditions or at risk of developing them. The costs of physical inactivity to the NHS were estimated as £900 million in 2015, which rose to £1.2 billion in 2017.

But evidence from one of the largest databases of the schemes does little to support their use, with researchers from London, Southampton and Sheffield arguing that improvements in health and well-being were so small that the impact was unclear, and that any UK roll-out ‘needs to be rethought to maximise their effectiveness’.

Data from 23,731 active participants in 13 different schemes, lasting between six weeks and three months, found ‘significant improvements’ in the participants’ weight, mental health and quality of life. However, the changes were deemed too small to meet the threshold to be clinically meaningful, meaning no firm conclusion on their impact can be drawn.

The authors wrote: “As noted, currently there is a lack of agreement of what constitutes ‘impact’ with respect to the evaluation of exercise referral schemes and the evidence presented here from one of the largest databases of them does little to support the use of them, broadly speaking. These findings support the need to consider exercise referral schemes, particularly their implementation, more critically, using real world data to understand how best to maximise their potential, particularly considering the known benefits of exercise and the research of exercise referral schemes across the UK.”

Ian Hudspeth, chairman of the Local Government Association’s Community Wellbeing Board, said: “Social prescribing schemes remain in their relative infancy on a national scale but are becoming increasingly popular as councils look to embed preventative approaches in the services that they provide.

“Locally-led, targeted interventions and facilities, such as museums, libraries, leisure centres and parks, have a major role to play in helping communities to become creative and physically active. Well-being is complicated and hard to measure. Outcomes can differ widely from one individual to another and are unpredictable. It is important that any social prescribing activity is properly resourced to allow evaluation and research to take place.”

Health Secretary Matt Hancock set out his ambition for every patient in the country to have access to social prescribing schemes on the NHS as readily as they do medical care in October.

The findings are published in the Journal of Epidemiology and Community Health.